Paediatric Surgery

Background: Preauricular sinus abscess is a sequellae of an infected squamous epithelial lined preauricular sinus tract, commonly seen in pediatric population. This study aim to determine the clinical profile of preauricular sinus abscess in Sokoto, Nigeria.Methods: This was a retrospective study carried out between June 2011 to May 2014 of all patients with preauricular sinus abscess that presented to the department of ear, nose and throat. Data extracted from clinical records were bio-data, duration of symptoms, and history of recurrence and associated congenital anomalies, sides of involvements, sensitivity results, treatments options and outcome. Data obtained were analyzed using simple statistical tables.  Results: Seventeen patients were seen during the study period with preauricular abscess (PA). There were 5    (29.4%) males and 12 (70.6%) females with a ratio M:F of 1:2.4. The age range was from 5-34 years. Prevalence of PA is high in the 1-10 years age group. Six patients ...

The Pan African Paediatric Surgery Association (PAPSA) was formed in 1994. The need for an organisation in Africa to voice children's surgery and the trials and tribulations in forming this organisation was covered in this journal 2 years ago (Heinz

Intussusception is the most common cause of Acute bowel obstruction in infants and toddlers. However, a Trans-anal protrusion of an intussusception (TAPI) is relatively rare and is not well reported in literature. A high index of suspicion is essential as the diagnosis is purely clinical, and often confused with rectal prolapse. Most patients present late due to neglect on the part of the parents or the primary treating physician. A late presentation usually results in a poor outcome and increased morbidity and mortality. Uncommonly these children may present early, where a prompt surgical management is desirable. The author reports a single case of a Trans anal protrusion of intussusception (TAPI) in a 1-½ -year old female child who was successfully managed in the author's resource-limited teaching institution without a dedicated pediatric surgery unit.

Background: Functional nanomaterials (FNMs) have transformed biomedical applications by enabling precise diagnostics, targeted therapies, and advanced regenerative techniques. Their use in paediatrics, however, demands careful adaptation to account for unique developmental, physiological, and immunological characteristics in children. Objective: To assess the current advancements, biomedical potential, and safety considerations of FNMs for paediatric healthcare, with a focus on overcoming translational barriers. Methods: A comprehensive review of peer-reviewed studies from PubMed, Scopus, and Web of Science (2015-2025) was conducted, prioritizing research on nanotechnology applications in paediatric diagnostics, drug delivery, imaging, and tissue engineering. Results: FNMs, including liposomes, polymeric nanoparticles, metallic nanoparticles, and carbon-based structures, demonstrate significant promise in managing paediatric cancers, infections, congenital disorders, and tissue regeneration. Notable examples include liposomal vincristine for acute lymphoblastic leukaemia (ALL) and PLGA nanoparticles for cystic fibrosis gene therapy. Challenges such as immunogenicity, long-term toxicity, and regulatory hurdles limit clinical adoption. Conclusion: FNMs offer transformative potential for paediatric healthcare but require tailored designs, rigorous toxicological profiling, and child-specific clinical trials to ensure safe translation. Ethical considerations and equitable access further underscore the need for multidisciplinary collaboration.

Background Recommendations by the Lancet Commission on Global Surgery regarding surgical care in low-and middle-income countries (LMICs) require development to address the needs of children. The Global Initiative for Children's Surgery (GICS) was founded in 2016 to identify solutions to problems in children's surgery by utilizing the expertise of practitioners from around the world. This report details this unique process and underlying principles. Methods Three global meetings convened providers of surgical services for children. Through working group meetings, participants reviewed the status of global children's surgery to develop priorities and identify necessary resources for implementation. Working groups were formed under LMIC leadership to address specific priorities. By creating networking opportunities, GICS has promoted the development of LMIC-LMIC and HIC-LMIC partnerships. Results GICS members identified priorities for children's surgical care within four pillars: infrastructure, service delivery, training and research. Guidelines for provision of care at every healthcare level based on these pillars were created. Seventeen subspecialty, LMIC chaired working groups developed the Optimal Resources for Children's Surgery (OReCS) document. The guidelines are stratified by subspecialty and level of health care: primary health center, first-, second-and third-level hospitals, and the national children's hospital. The OReCS document delineates the personnel, equipment, facilities, procedures, training, research and quality improvement components at all levels of care. Conclusion Worldwide collaboration with leadership by providers from LMICs holds the promise of improving children's surgical care. GICS will continue to evolve in order to achieve the vision of safe, affordable, timely surgical care for all children. Since the conclusion of the United Nations' Millennium Development Goals (MDGs) and through the ongoing work toward Sustainable Development Goals (SDGs), tremendous progress has been made toward reducing childhood mortality . However, the care of children with surgical diseases remains an underappreciated and underfunded area in health care, despite congenital Collaborating members are listed in the Acknowledgments.

Introduction: Perioperative strategies have been changing due to the COVID-19 pandemic to prevent the risk of postoperative complications and transmission of infection. This study was aimed to assess the outcome of gastrointestinal surgery and the risk of transmission by implementing COVID-19 testing criteria and surgical strategy. Method: This was a retrospective descriptive study conducted at the department of surgery at Patan Hospital, Nepal, during COVID-19 lock-down from 24 march to 15 June 2020. All patients who underwent gastrointestinal (GI) surgery were included. High-risk patients (as defined by the Hospital Incident Command System, HICS) were tested for COVID-19 preoperatively. Surgery was performed in COVID operating room with full protective gear. Low-risk patients were not tested for COVID-19 preoperatively and performed surgery in non-COVID OR. Data from patient’s case-sheets were analyzed descriptively for age, gender, comorbidities, hospital stay, RT-PCR results, su...

Background: Infectious diseases have always been the lime light of global health with very little focus on childhood surgical conditions despite the fact that children constitute about half of the population in LMICs. A significant proportion of the burden of global disease can be reduced by surgical intervention. South Africa is one of the pioneers of the practice of paediatric surgery in Africa with a great burden of paediatric surgical conditions. Few studies, if any, have investigated the burden of operative paediatric surgical procedures in South Africa. Therefore, this retrospective study aimed to look at the scope of operative paediatric surgical procedures at the Chris Hani Baragwanath Academic Hospital (CHBAH) based in Johannesburg, South Africa, and reports on the numbers of elective and emergency procedures over a 12-month study period. Results: There were 1699 operative general paediatric surgical procedures of which 61.7% were electives and 38.3% were emergencies. The scope of general paediatric surgical conditions operated on fell under the categories of congenital anomalies, infections and tumours. Of these, surgeries for congenital anomalies were performed in almost all the subspecialties. There is a high operative paediatric surgical burden at the CHBAH. The role of paediatric surgical care as an essential component of global health cannot be underrated.

Background: Various treatment modalities have been applied for the management of infantile hypertrophic pyloric stenosis. However surgery remains the mainstay of treatment for IHPS of which Ramstedt's pyloromyotomy remains the surgical technique of choice. Objective: To see the outcome of surgical management of infantile hypertrophic pyloric stenosis by double-Y pyloromyotomy. Methods: A prospective interventional study of 40 patients with IHPS was carried out over a period of 2 years from July 2008 to July 2010. The patients were divided into 2 equal groups of 20 patients in each. All patients selected for study were optimized preoperatively regarding to hydration, acid-base status and electrolytes imbalance. All surgeries were performed after obtaining informed consent. Standard preoperative preparation and postoperative feeding regimes were used. The patients were operated on an alternate basis, i.e., one patient by Double-Y Pyloromyotomy (DY) and the next by a Ramstedt's...

Introduction: Approximately one in three men is circumcised globally, but there are relatively few data on the safety of the procedure1. Circumcision is a surgical procedure performed for centuries for medical, religious and several other reasons. Circumcision is the most common surgical procedure performed in boys through out the world. Meatal stenosis is one of its late complications. We evaluated the topical use of lubricant jelly (Vaseline- petroleum jelly) after circumcision in boys in order to reduce or prevent the risk of meatal stenosis.Objective: To see the effectiveness of use of lubricants and to determine the functional outcome, that is prevention of post circumcision meatal stenosis.Materials and Methods: A randomized control trial was performed, in which two groups of boys younger than two years old underwent circumcision according to dissection (sleeve) method . The parents in the study groups were strictly instructed to use petroleum jelly on the meatus and circumcis...

The study of the comparative morphology of humans and mammals - laboratory animals used in experimental studies, is of great importance for improving diagnostic and therapeutic measures in clinical medicine. The study of histotopography and morphoarchitectonics of ontogenetic transformations of the lower urinary tract of humans and laboratory mice in a comparative aspect is relevant for the development of simultaneous morphological scientific directions - tissue engineering, molecular medicine and reconstructive xenotransplantation.
Aim of the study. To determine the main patterns and chronological sequence of prenatal ontogenesis of organs and structures of the lower urinary tract of humans and laboratory mice.
Material and methods. The study was conducted on 14 series of consecutive histological sections of human embryos and pre-fetuses aged from 4 to 11 weeks of intrauterine development (IUD) and 15 series of histological sections of laboratory mouse embryos and pre-fetuses. The material was used from the collection of the Department of Histology, Cytology and Embryology of the Bukovina State Medical University. A complex of morphological research methods was applied (anthropometry, morphometry, microscopy, three-dimensional computer reconstruction, statistical analysis). To compare the periods of prenatal development of humans and laboratory mice, periodization according to the Carnegie stages (CS) was used.
Results. In both species, at the IUD stage CS 11, hematopoietic foci in the mesoderm of this provisional organ were detected. During the subsequent stages CS12-14, the epithelium lining it becomes multilayered, an increase in cell density is noted, which may be associated with the increasing functional demands placed on this structure. The features of the syntopy of the allantois at the stage CS16 of human embryos (end of the 5th week of gestation) and laboratory mouse (day 12 of gestation) are characterized by its location between the umbilical arteries, and its caudal part is connected to the urogenital sinus, which has not yet been completely separated from the rudiment of the rectum. In human and laboratory mouse embryos up to the stage of development CS23, processes of atrophy of the allantois are observed, which is transformed into a cellular cord, and together with the reduced remnant of the yolk sac is located among the structures of the umbilical cord. During the morphological analysis of the features of the development of the urinary bladder of the laboratory mouse, the ratio of the thickness of its membranes was determined using morphometry of histological preparations, as well as on 3D reconstructions of serial consecutive sections of the lower urinary tract. It was established that from the stage of development CS17 to CS23 in the laboratory mouse, the size of the urinary bladder increases 12 times. Features of the proliferation and differentiation of the muscular membrane of the urinary bladder of the laboratory mouse are observed, which are characterized by a wave-like process that begins from the cranial part of the organ laying (CS17 embryos) and is directed in the caudal direction (CS19 embryos). During the stage CS21, the development of smooth myocytes increases the total thickness of the muscular membrane. At stage CS23, all parts of the bladder of a laboratory mouse demonstrate a developed muscular coat, in which unidirectional bundles of muscle fibers can be distinguished, which indicates the beginning of the formation of muscle layers and, in particular, the bladder detrusor muscle.
Conclusions. 1. Comparison of the patterns of morphogenesis of the lower urinary tract in humans and laboratory mice using the Carnegie scale of prenatal development periods demonstrates the similarity of stage ontogenetic transformations, but at the microscopic level, differences were found that indicate a less differentiated bladder detrusor muscle and a relatively faster time of formation of the definitive structure of the urinary bladder. 2. In human and laboratory mouse embryos at the CS23 stage, the structures of the urinary bladder acquire the features of a definitive organ. 3. The general trends of differentiation of the muscular membrane of the urinary bladder of the laboratory mouse have a wave-like character: the process begins from the cranial part of the bladder lining and is directed in the caudal direction. 4. The ratio of layers of the bladder wall of a laboratory mouse at CS17 was: 55% - the lamina propria of the mucous membrane, 5% - its epithelial lamina (urothelium), 5% - the adventitia (or serous) membrane, 35% - the muscularis mucosa. At the stage of CS23, there is a decrease in the relative thickness of the adventitia (or serous) membrane and an increase in the muscularis mucosa of the bladder to 70% relative to its wall.

Introduction: Aside from religious circumcisions, the indications for circumcision are few. However, in the cultural context, many patients are unnecessarily referred for circumcision for physiological phimosis (adhesions). Due to parental concerns and misperceptions by general practitioners, nonretractile prepuce is one of the most common indications for referral to a paediatric surgeon in many countries. This study aimed to determine whether preputial adhesiolysis successfully managed symptomatic non-retractile foreskin and therefore prevented the need for circumcision. Methods: A retrospective review was performed of the health records of children who presented with preputial adhesion. We included 65 symptomatic patients (ballooning of the prepuce in all cases and additional dysuria in three cases) who underwent preputial adhesiolysis. All cases were followed up for 2 years. Circumcision was subsequently carried out for patients who developed fibrous scarring resulting in difficu...

Background: Neuroblastoma, a common pediatric malignancy, exhibits diverse clinical behavior, necessitating evolving management strategies. This review examines historical milestones, current risk-adapted protocols, and emerging therapies, with insights for resource-limited settings like India. Methods: A systematic search (1950-March 2025) across PubMed, EMBASE, and Cochrane Library identified 40 studies (15 trials, 20 cohorts, 5 reviews) on pediatric neuroblastoma management. Data on interventions, survival, and complications were extracted, with quality assessed using standardized tools. Narrative synthesis was conducted per PRISMA guidelines. Results: Early surgical approaches yielded poor outcomes, but chemotherapy (1960s), MYCN amplification discovery (1985), and INRG risk stratification (2009) improved survival. Low-risk cases achieve >90% overall survival (OS) with surgery, intermediate-risk 94-96% OS with chemotherapy, and high-risk cases approach 50% OS with multimodal therapy, including tandem ASCT and immunotherapy. Emerging therapies (ALK inhibitors, MIBG, CAR T-cells) show promise but face access barriers in India. Conclusion: Neuroblastoma management has advanced significantly, but challenges like relapse, late effects, and resource disparities persist, particularly in India. Precision medicine and localized strategies are critical for future progress.

Background: Esophageal atresia (EA) with tracheoesophageal fistula (TEF) is a congenital anomaly with varied anatomical presentations. The double fistula variant, where both proximal and distal esophageal segments connect to the trachea, poses significant diagnostic and therapeutic challenges, often undetected until surgery or later complications arise. Objective: This study aims to consolidate evidence on the incidence, diagnostic strategies, surgical management, and outcomes of double fistula in EA patients. Methods: We conducted a systematic review following PRISMA guidelines, searching PubMed, Embase, Web of Science, and Cochrane Library up to September 2024. Studies reporting double fistula in EA were included, with data extracted on patient demographics, diagnostic modalities, surgical techniques, complications, and outcomes. A random-effects model was used for meta-analysis.

Background Congenital diaphragmatic hernia (CDH), despite the advances in perinatal care is still a menacing disease carrying high mortality and morbidity. The review in this current update critically examines the development of antenatal management of CDH over the past four decades methodically. Methods A systematic literature search using the PubMed, Embase, Cochrane Library, and Web of Science databases for studies on CDH in the last 4 decades i.e from 1980 to 2024, was performed. The following search terms in varying combinations were included: congenital diaphragmatic hernia, antenatal management, fetal therapy, prenatal diagnosis, and fetal intervention. PRISMA guidelines were followed for the purposes of study selection and data extraction. The studies were divided based on management strategy and timeline order to look for patterns of evolution. Results Screening of 1,472 records yielded 187 pertinent studies. Antenatal treatment of CDH has evolved through four phases: (1) initial diagnostic approaches (1980s); (2) developing prognostic predictors (1990s); (3) experimental fetal treatments (2000s); and (4) evidence-based optimized approaches (2010s to date). Among the most important developments are improved imaging techniques, calculation of lung-to-head ratio (LHR) and observed-to-expected LHR, fetal endoscopic tracheal occlusion (FETO), and protocolized evaluation. Current practice puts focus on multidisciplinary care, proper risk stratification, and early referral to secondary-level facilities. Conclusion Antenatal management of CDH has been revolutionized from the time of initial diagnosis to high-technology intervention methods. Present care is focused on accurate prenatal diagnosis, proper case selection for therapy, and optimal perinatal management. While the mortality due to CDH has reduced over the last few decades, we still need more studies to zero in on the optimal timing of interventions, to optimize selection criteria for antenatal management, and to be able to introduce new therapeutic interventions.

Operating on children has always required a careful balance between meeting immediate surgical needs and ensuring their future growth. Unlike adults, pediatric patients experience ongoing anatomical and physiological changes, which complicates traditional treatment methods. Biomaterials now provide innovative solutions that align with a child's development while reducing long-term risks. This review examines how modern biomaterials are changing the field of pediatric surgery. It touches upon tissue-engineered grafts that adapt to children's growing organs to advanced wound dressings that promote healing in the delicate skin of kids. I have tried to highlight advances across various pediatric sub-specialties-for example in reconstructing congenital defects, developing growthfriendly implants, or utilizing various regenerative therapies to repair damaged tissues. The paper focuses on materials such as biodegradable polymers, biologically derived scaffolds, and bioactive ceramics, with a view to outlining their practical applications and limitations. However, adapting these technologies for children presents challenges. The review also addresses the following key issues: Ensuring materials remain safe and effective as young bodies grow, tackling ethical concerns regarding lifelong implant use, and navigating regulatory hurdles in pediatric device approval. The future holds promise, what with the like of personalized 3D-printed tissues, shapeshifting "intelligent" materials, and bioengineered organs. We need to remember that children are not just small adults. Their care requires materials and strategies that are as dynamic as their growth. By focusing on solutions that evolve with kids rather than merely treating them, we can elevate pediatric surgery from a field of compromise to one of enduring healing.

Aims: Pediatric urologists routinely face emotionally charged clinical scenarios, including life-altering diagnoses, patient mortality, and ethical dilemmas. These experiences often lead to unresolved emotional residue, which can manifest as burnout, compassion fatigue, or somatic symptoms. This qualitative study explores how pediatric urologists process defining moments of loss and moral distress, and evaluates mindfulness-based interventions to mitigate their psychological burden. Methods: Participants filled out a questionnaire attached in Appendix A, which was anonymized and then reviewed to get results. The study included 24 pediatric urologists across tertiary care centers in India. Narratives were analyzed using thematic coding. A pilot mindfulness intervention (5-minute diaphragmatic breathing) was trialed with 12 participants. Results: Four key themes emerged: (1) anchoring trauma (76% reported recurrent intrusive thoughts about patient deaths), (2) emotional suppression (89% normalized compartmentalization as a coping mechanism), (3) somatic manifestations (63% linked unresolved grief to chronic insomnia or hypertension), and (4) healing through introspection (mindfulness practitioners showed a 40% reduction in burnout scores). Conclusion: Unaddressed emotional trauma in pediatric urology correlates with diminished professional fulfillment and physical health. Institutional support systems, including mindfulness training, may foster resilience.

Purpose. The purpose of this study was to evaluate the safety and effi cacy of ultrasound-guided high-intensity focused ultrasound (USgHIFU) for ablation of solid tumours without damaging the surrounding structures. Materials and methods. A specifi c written informed consent was obtained from every patient before treatment. From September 2008 to April 2009, 22 patients with 29 lesions were treated: nine patients with liver and/or softtissue metastases from colorectal carcinoma (CRC), six with pancreatic solid lesions, three with liver and/or bone metastases from breast cancer, one with osteosarcoma, one with muscle metastasis from lung cancer, one with iliac metastasis from multiple myeloma and one with abdominal liposarcoma. The mean diameter of tumours was 4.2 cm. All patients were evaluated 1 day, 1 month and 3 months after HIFU treatment by multidetector computed tomography (MDCT), positron-emission tomography (PET)-CT and clinical evaluation. The treatment time and adverse events were recorded. Results. All patients had one treatment. Average treatment and sonication times were, respectively, 162.7 and 37.4 min. PET-CT or/and MDCT showed complete response in 11/13 liver metastases; all bone, soft-tissue and pancreatic lesions were palliated in symptoms, with complete response to PET-CT, MDCT or magnetic resonance imaging (MRI); the liposarcoma was almost completely Riassunto Obiettivo. L'obiettivo di questo studio è stato quello di valutare la sicurezza e l'effi cacia dell'applicazione degli ultrasuoni focalizzati ad elevata intensità (USgHIFU) nell'ablazione terapeutica di tumori solidi senza danneggiare le strutture circostanti. Materiali e metodi. Uno specifi co consenso informato scritto è stato ottenuto da tutti i pazienti prima del trattamento. Da settembre 2008 ad aprile 2009 sono stati trattati 22 pazienti con 29 lesioni: 9 pazienti con metastasi epatiche e/o dei tessuti molli da carcinoma del colon retto (CRC), sei pazienti con lesioni solide del pancreas, tre con metastasi epatiche e/o ossee da tumore mammario, uno con osteosarcoma, uno con metastasi muscolare da tumore del polmone, uno con lesione iliaca da mieloma multiplo ed uno con liposarcoma addominale. Il diametro medio era di 4,2 cm. Tutti i pazienti sono stati valutati ad 1 giorno, 1 mese e a 3 mesi di distanza dal trattamento HIFU con tomografi a computerizzata multidetettore (MDCT), tomografi a computerizzata con tomografi a ad emissione di positroni (PET-CT) e valutazione clinica. La durata del trattamento e gli eventi avversi sono stati registrati. Risultati. Tutti i pazienti sono stati trattati in una unica sessione. Il tempo medio di trattamento e di sonazione sono stati di 162,7 e 37,4 minuti, rispettivamente. PET-CT e/o MDCT hanno mostrato risposta completa in 11/13 metastasi epatiche; tutte le lesioni ossee, dei tessuti molli e ABDOMINAL RADIOLOGY RADIOLOGIA ADDOMINALE

OBJECTIVES: Few experiences comparing paediatric and adult patients treated for pulmonary sequestration (PS) have been reported. Surgical treatment is considered the best choice, but the time of surgery is still controversial. We present our experience in this setting, comparing characteristics, histological results and outcome of paediatric and adult patients undergoing PS resection. METHODS: Between 1998 and 2017, a total of 74 patients underwent lobectomy or sublobar resection for PS. Sixty patients were children (group A: < _16 years old) and 14 were adults (group B: >16 years old). Preoperative diagnosis was radiological. PS was intralobar (42 cases) and extralobar (32 cases). The operation was a muscle-sparing lateral thoracotomy or video-assisted thoracoscopic surgery. Preoperative characteristics, histological results and short-/long-term results of the 2 groups were retrospectively analysed and compared.

Background: Lymphangiomas are rare congenital malformations that and pose a specific challenge in the pediatric age group and require effective therapeutic intervention. In our systematic review we look at how bleomycin therapy for lymphangiomas has evolved across the five decades from (1977-2024). Methods: We conducted a systematic literature review of 127 studies, via a comprehensive search of a plethora of databases including PubMed/MEDLINE, Embase, and Cochrane Library. This analysis of studies allowed us to chart the gradual transition from surgery being the mainstay of treatment to bleomycin becoming a preferred treatment modality. Results: Analysis of our observations showed that our current success rates for bleomycin therapy range from 60-88%, with huge age dependent variations in the treatment responses. Protocol refinement has led to a significant improvement in standardization of therapy. Optimal concentration of 1 IU/mL with maximum cumulative therapy dose of 15 IU/kg are the established standards now. Conclusions: Recent advances in molecular pathophysiology have yielded promising results from combination therapy approaches which suggests new avenues for more efficacious treatment methods. We propose structured evidence based recommendations which emphasise the standardisation of protocols whilst incorporating personalized therapy based on lesion morphology and patient characteristics.

GIST are mesenchymal tumours of the gastro-intestinal tract, that occurs frequently in the stomach. They are often asymptomatic, but may present as an acute or recurrent bleeding at first clinical presentation. CT scan and endoscopy may be helpful for diagnosis, while PET in more useful in the follow-up. Molecular analysis with the detection of the KIT (CD117) marker, may suggest the diagnosis in the 95% of cases. Surgery is the treatment of choice, but a multidisciplinary approach is very important to achieve a good result and to improve the prognosis of these tumours. Case reports: We report three cases of gastric GIST that presented in different clinical ways: massive bleeding with liver matastasis, completely aymptomatic, and locally advanced gastric tumour with massive bleeding and consequent incomplete resection. All the three patients had total gastrectomy but only in one case we performed a radical surgery. Molecular therapy let us achieve a good control even in the advanced disease. Discussion: The clinical, radiological and pathological features of these tumours and their impact on prognosis are discussed. The size and the proliferation index are the most important factors predictive for a good outcome. Conclusions: Gastric GIST is a multiform tumour that may have different clinical presentations. A radical surgical approach followed by molecular therapy is the gold standard.

ntroduction: Desmoids of the chest wall are benign and rare tumors that usually arise from the fascia of the pectoralis major muscle, uncommonly from the mammary gland. These tumors sometimes can be locally aggressive, infiltrating surrounding tissues. Clinically they can appear suspicious for malignancy, as palpable and firm masses infiltrating the pectoral muscles. Case reports: We report the cases of a two young women with an extra-abdominal desmoid. The first case is a pectoralis major desmoids; the patient underwent a wide excision with clear margins and after a follow-up of 12 months is disease free. The second case is about a desmoid arising from the mammary gland. This patient had a wide mammary resection, but one mammary margin was closed; in consideration of the need of a more aggressive surgery in front of a benign disease, the patient refused a further treatment with knowledge of the risk of recurrence. Discussion: The desmoid tumors are rare and benign diseases that can...

Background: Wearable devices have grown into much more than gadgets for counting steps-they're now trusted tools in pediatric surgery and urology. For kids, they make a big difference by watching their health all the time, catching issues before they get worse, and helping doctors create care plans that fit each child's needs, which is so important when working with little ones who can't always tell us how they feel. This paper explores how these tools are helping, the problems we're running into, and what's coming next to make things even better.

Methods: I reviewed studies from 2020 to 2025 that focus on wearable technologies in pediatric surgery and urology, diving into how these devices work, their real-world results, and what affects their use, like engineering designs and rules for medical devices.

Results: In pediatric surgery, smart patches can spot wound infections with 92% accuracy, while chest sensors cut anesthesia-related issues by 30% during recovery. In urology, wearable bladder sensors help track pee patterns in kids with vesicoureteral reflux (VUR), and smart belly patches keep tabs on babies in the womb at risk for hydronephrosis, a kidney swelling condition. But there are hurdles: Motion sensors often miss the mark by 5-15% in active kids, 40% of families stop using these devices within 6 months, and there aren't enough clear rules for kid specific wearables. New ideas, like sensors that dissolve after use and AI tools to analyze data, could help solve these problems.

Conclusion: Wearable technologies can truly change how we care for kids in surgery and urology by offering constant updates and quick action when something's wrong. Still, we need to work together-engineers, doctors, and lawmakers-to fix issues like spotty accuracy and kids not wanting to wear them, so these tools can do their best. Looking ahead, I see a future with gentler, kid-friendly designs that work smoothly with online doctor visits.

Background: In children, mesenteric volvulus albeit rare, can closely mimic acute appendicitis. This overlap in symptoms (abdominal pain, vomiting, fever) often delays diagnosis, leading to the risk of bowel ischemia. We describe five cases where volvulus was initially mistaken for appendicitis, stressing the need for vigilance in pediatric abdominal emergencies. Methods: Between 2020 and 2024, five children (ages 2-12) underwent surgery for mesenteric volvulus at my tertiary care pediatric center; after presenting with rightsided abdominal pain and vomiting suggestive of appendicitis. We analyzed their clinical course, imaging results, and surgical outcomes retrospectively. Results: Initial ultrasounds raised uncertainty in three cases, while one hinted at appendicitis. CT scans, however, spotted the whirlpool sign-a hallmark of volvulus-in all patients. Surgery confirmed twisted bowel segments, with three cases linked to congenital malrotation. Detorsion relieved the twist, and three children required a Ladd's procedure. One patient lost 20 cm of necrotic bowel, leading to short bowel syndrome. Four recovered smoothly; the fifth needed prolonged nutritional support. Conclusion: When kids present with appendicitis-like symptoms but unclear imaging, mesenteric volvulus must be ruled out. CT scans are pivotal for spotting the whirlpool sign. Immediate surgery prevents bowel loss, especially in malrotation cases. Clinicians should always keep this rare diagnosis in their list of differentials to avert life-altering complications.

Soft tissue sarcomas are rare in children, constituting approximately 7% of all pediatric malignancies. These tumors have nonspecific clinical features and histological variability and so present diagnostic challenges. This case report presents the case of a 7-year-old girl with a high-grade spindle cell sarcoma of the right thigh, highlighting the histopathological findings, surgical intervention, and clinical outcome. The work has been reported in accordance with the SCARE criteria [1]. Case Presentation A 7-year-old female presented to the pediatric outpatient department with a 6-month history of a painless mass in the right thigh. It gradually grew from an incidentally detected small lump to the

Pediatric urology in India presents unique challenges and opportunities, shaped by a diverse healthcare landscape and cultural nuances. This article explores the integration of advanced minimally invasive surgical (MIS) techniques, such as 3D laparoscopy and robotics, with holistic wellness practices to revolutionize pediatric urological care. Conditions like vesicoureteral reflux, hypospadias, and congenital anomalies of the kidney and urinary tract (CAKUT) are prevalent, yet disparities in healthcare access, particularly in rural areas, and cultural stigmas often delay timely intervention. The author, a practicing pediatric urologist, highlights the transformative potential of MIS, which offers precision, smaller incisions, and faster recovery, though high costs and limited training hinder widespread adoption. Complementing surgical advancements, holistic approaches incorporating psychological support, nutrition, Ayurveda, and yoga enhance recovery outcomes. Community engagement and cultural sensitivity are emphasized as critical to overcoming barriers and fostering awareness. Despite challenges like the shortage of specialists and high equipment costs, innovations like telemedicine and single-port robotics offer hope for equitable care. This article advocates for a child-centric paradigm that blends cutting-edge technology with compassionate, culturally attuned care to ensure a healthier future for India’s children.

Lo scopo di questo lavoro di ricerca è stato quello di approfondire le conoscenze sul linfoma del cane, cercando di non considerare più questa malattia come un unico disordine linfoproliferativo ma come diverse entità clinico-patologiche, proprio come avviene in medicina umana. Per questo motivo, dopo un primo studio approfondito dei diversi tipi di linfoma dell’uomo, si è cercato di adattare lo stesso tipo di classificazione (WHO e REAL) ai casi di linfoma diagnosticati nei nostri cani. I casi inclusi in questo studio riguardano animali che sono stati presentati direttamente alla visita clinica alla Facoltà di Medicina Veterinaria di Lione, oppure sono casi raccolti da altri laboratori di patologia localizzati sempre nel territorio francese. Gli animali sono stati sottoposti a visita clinica completa di esami emato-biochimici, radiografia toracica, ecografia addominale e spesso esame del midollo osseo. La diagnosi di linfoma si è ottenuta tramite analisi citologiche e/o istologiche...

Background Labial synechiae is a common condition in prepubertal girls characterized by adhesion of the labia minora. Typically, these adhesions originate from the posterior fourchette and advance anteriorly. While most cases are asymptomatic, some present with urinary symptoms. This case series highlights three unusual presentations of labial synechiae with distinct urinary manifestations. Methods We retrospectively reviewed three pediatric cases of labial synechiae with atypical presentations seen at our tertiary care center between January 2022 and December 2023. Patient demographics, presenting symptoms, physical examination findings, treatment modalities, and outcomes were documented. Results The three cases (ages 3, 4, and 5 years) presented with distinct urinary symptoms: bifid urinary stream, post-void dribbling, and dysuria with urinary retention, respectively. Notably, all three demonstrated atypical patterns of labial adhesions: mid-labial fusion with patent anterior and posterior openings, anterior fusion with posterior patency, and asymmetric lateral fusion, respectively. All cases were successfully managed with a combination of manual separation and topical estrogen therapy, with no recurrence at 6-month follow-up. Conclusion This case series highlights the diverse clinical presentations of labial synechiae beyond the classical pattern. Clinicians should consider labial synechiae in the differential diagnosis of various urinary symptoms in prepubertal girls and perform careful genital examination. Early recognition enables simple, effective treatment and prevents unnecessary investigations and psychological distress.

I processi di invecchiamento che interessano tutti i tessuti del corpo e che danno, come risultato, un declino dell'efficienza circolatoria e neurofisiologica non risparmiano l' apparato genitale e molte delle normali senescenze possono essere addebitate a questi motivi generali» (KAPLAN). L'interesse per la senescenza sessuale maschile (detta anche impropriamente andropausa) eanco-

Background: Vesicoureteral reux (VUR) is a common urological condition in children where urine ows backward from the bladder to the
kidneys, potentially causing infections and kidney damage. While traditional open surgery has been the standard treatment for decades, minimally invasive approaches are becoming increasingly popular. This paper shares our experience with laparoscopic ureteral reimplantation for treating VUR in children.
Methods: We reviewed records of 87 children (134 ureter procedures) who underwent laparoscopic extravesical ureteral reimplantation for grades III-V VUR at our hospital between 2015 and 2022. We analyzed patient information, surgical details, outcomes, and long-term follow-up data. Surgical success was dened as the absence of VUR on follow-up voiding cystourethrography and resolution of clinical symptoms.
Results: The average patient age was 5.7 years with more girls than boys (ratio 2.6:1). Over half the patients had the condition in both kidneys. Operations took about 2 hours for one side and 2.7 hours for both sides. Children typically stayed in the hospital for less than 3 days. Some temporary complications occurred, including voiding difculties (8%), urinary infections (5.7%), and a few cases requiring reoperation (3.4%).
With nearly 5 years of follow-up, our success rate was 96.6%, with 94.3% of patients remaining infection-free long-term.
Conclusions: Laparoscopic surgery is a safe and effective minimally invasive alternative to traditional open surgery for children with VUR. Our long-term results show excellent outcomes with minimal complications, shorter hospital stays, and better cosmetic results compared to conventional surgery

Background: Lower urinary tract dysfunction (LUTD) affects 17-22% of children globally. While urodynamic studies (UDS) remain the gold standard for diagnosis, tailored approaches optimizing diagnostic resources may improve patient compliance and outcomes. This study evaluates the efficacy of a comprehensive diagnostic algorithm incorporating clinical assessment, invasive uroflowmetry, and complete urodynamic studies in diagnosing and managing pediatric LUTD. Methods: We conducted a prospective observational study of 33 children (ages 2-12 years) with LUTD symptoms without structural or neurological abnormalities from June 2021 to July 2023. Patients were categorized into Non-LUTD (< 4 years) and LUTD (≥ 4 years) groups based on symptom onset. Assessment included detailed history, physical examination, voiding diaries, ultrasonography, VCUG, cystoscopy, invasive uroflowmetry, and comprehensive UDS. Management strategies were implemented based on accurate urodynamic diagnoses with regular follow-up assessments. Results: Complete follow-up data was available for all 33 patients (19 males, 14 females). In the Non-LUTD group (n=16), all patients presented with bilateral hydroureteronephrosis and thickened bladder walls. Vesicoureteral reflux (VUR) was identified in 11/16 cases, with varying UDS findings despite similar clinical presentations. The LUTD group (n=17) showed diagnoses of: overactive bladder (41%), detrusor-sphincter dyssynergia (18%), detrusor overactivity (24%), and hypoactive bladder (18%). Invasive uroflowmetry combined with comprehensive UDS provided definitive diagnoses in all cases, with 17.6% of patients showing discrepancies between initial clinical assessment and final urodynamic diagnosis. All patients demonstrated symptomatic improvement with targeted management based on precise urodynamic findings. Conclusions: A comprehensive approach incorporating detailed clinical assessment, invasive uroflowmetry, and complete urodynamic studies provides precise diagnosis and effective management of pediatric LUTD. While clinical evaluation remains foundational, confirmatory urodynamic assessment enables tailored therapeutic interventions with superior outcomes. Level of Evidence: III-Prospective observational study with systematic follow-up and objective outcome measures.

Background Tracheostomy is one of the surgical procedure developed in early times of civilization. Since then it has remain as one of the lifesaving surgical procedure worldwide. In Bugando Mwanza the referral and teaching hospital two studies has been done about tracheostomy but the details of the late complication is not well established also the clinical indications varies in both studies. Therefore these study will enlightening more on the clinical indications and give details on the late complications that results due to tracheostomy. Methods: This was 4 years and 2 months retrospective study; conducted at Otorhinolaryngology Head and Neck department at Bugando Medical Centre from November 2019 to December 2023. Data were retrieved from patients' files kept in medical record department and analyzed using SPSS. Results: One hundred and ninety patients had tracheostomy during the study period. Among them, one hundred and eight patients (56.8%) were male, and eighty-two (43.2%) were female. Their ages ranged from 18 years to 91 years with the mean age of 51.55 (SD 17.97) years. The majority of the patients were above 60 years (72%). The most common indication of tracheostomy was upper airway obstruction secondary to tumor accounting 59.5%, followed by respiratory failure accounting 24.7%, followed by upper airway obstruction due to traumatic causes and COPD which each accounted for 7.9%. The majority of tracheostomies (98.9%) were performed as emergency, and 2 patients (1.1%) had elective tracheostomy. %; Leading complication were tracheostomy tube blockage by 15.79% followed by hemorrhage and tracheostomy dependency by 7.89% then stoma infection by 7.37%. Conclusion: upper airway obstruction secondary to tumor is the most common indication for tracheostomy in our Centre and the leading complications were tracheostomy tube blockage by 15.79% followed by hemorrhage and tracheostomy dependency by 7.89% then stoma infection by 7.37%.

Scopo. Scopo del nostro studio è confrontare l'utilizzo del SonoVue versus TC spirale nella valutazione di efficacia terapeutica dei tumori renali trattati con Radiofrequenza (RF). Metodi. Sono stati trattati con ago freddo (Radionics, Boston MA), 18 pazienti portatori di 18 lesioni delle dimensioni di 2.7-6 cm (media 2.6). Qundici su 18 pazienti erano stati giudicati inoperabili per compromissione delle condizioni generali o per la presenza contemporanea di malattia neoplastica in altro distretto. Tre pazienti avevano rifiutato l'intervento. Due lesioni presentavano localizzazione centrale, 2 presentavano localizzazione mista e 14 localizzazione periferica e/o esofitica. La valutazione di efficacia terapeutica è stata effettuata ad un mese dal trattamento, ogni 4 mesi nel primo anno ed ogni 6 mesi dal secondo anno. E' stata eseguita TC spirale multislice (Light Speed Plus; GE Medical Systems, Milwaukee, WI) o RM e valutazione ecografica (Acuson, Sequoia; APLIO, Toshiba) con mezzo di contrasto (SonoVue; Bracco, Milano, Italia) 2.4 ml ev/bolus. Sei su 18 pazienti presentavano alterazione della creatininemia. Risultati. La valutazione TC ed ecografica è stata eseguita indipendentemente, in maniera blinded, da quattro radiologi e rivalutata in consensus conferences. La TC ha identificato residuo di malattia in 8/18 lesioni, mentre la CEUS (Contrast-Enhanced Ultrasonography) in 6/18 lesioni. Conclusioni. Nella valutazione di efficacia terapeutica, la CEUS eseguita nel follow-up dei pazienti trattati, si è rivelata una tecnica di imaging accurata sicura ed efficace. Considerando la differente tossicità del mezzo di contrasto utilizzato in TC e l'assenza di radiazioni, la CEUS potrebbe essere utile in pazienti oncologici con alterata creatininemia. Aim. To compare the accuracies of contrast-enhanced ultrasound (CEUS) and multislice CT in the evaluation of local recurrence following radiofrequency (RF) ablation of renal cell carcinoma (RCC). Materials and methods. Eighteen patients with 18 RCCs ranging between 2.7-6.0 cm in diameter (mean 2.6 cm) underwent RF ablation with internally-cooled electrodes (Radionics, Boston MA). Fifteen had been judged inoperable due to the presence of other neoplastic disease or poor general conditions, and the other three had refused surgery. Six of the 18 patients had mildly elevated serum creatinine levels. Two of the RCCs were located in the center of the kidney, 14 were in the periphery, and two had mixed locations. The therapeutic response was assessed one month after the procedure, every 4 months during the first year, and every 6 months thereafter. At each visit, the patient underwent multislice CT (light Speed Plus; GE Medical Systems, Milwaukee, WI) or MRI and CEUS with a second-generation microbubble agent (SonoVue; Bracco, Milan, Italy) (2.4 ml IV bolus). Results. All studies were reviewed in a blinded fashion at a consensus conference in which four of the authors participated. Residual viable tumor foci were identified in 8/18 lesions by CT and in 6/18 by CEUS. Conclusions. In the follow-up of patients with inoperable RCC treated with RF ablation, CEUS is a safe and accurate imaging technique for assessment of therapeutic efficacy. The toxicity profile of the US contrast agent and the absence of radiation exposure make CEUS particularly useful for repeated study of patients with neoplastic disease and elevated creatinine levels.

L’albero bronchiale rappresenta la piu frequente sede di origine di tumori carcinoidi (circa 25% del totale). Essi rappresentano il primo stadio nella differenziazione dei tumori neuroendocrini del polmone che va da neoplasie a bassa malignita (carcinoidi) sino a forme estremamente aggressive come il microcitoma. La diagnosi delle forme ben differenziate (carcinoidi) parte dalla sintomatologia di presentazione, rappresentata prevalentemente da sintomi di tipo respiratorio ostruttivo nelle sole forme centrali, mentre le forme periferiche tendono ad essere scoperte accidentalmente e tardivamente in quanto asintomatiche. Sindromi paraneoplastiche cliniche o subcliniche sono presenti in una minoranza di casi. L’iter diagnostico include la TC multislice, l’endoscopia bronchiale e l’Octreoscan con Single Photon Emission Computed Tomography (SPECT) del torace. Un possibile contributo puo essere in un immediato futuro quello della PET-TC con 5-idrossitriptofano (5-HTP) e con (68), Ga-DOTA-D...

The thyroglossal duct cyst is one of the most common lesions in the midline of the neck and is found in around 7% of the population.
They often present as painless neck swellings that move in response to tongue protrusion and during deglutition. We describe a case of
thyroglossal duct cyst that was atypical in that the cyst was distant from the midline, it did not move in response to tongue protrusion,
and the swelling was significant that resembled a colloid goiter. A 36-year-old male presented to the surgical outpatient department with
a complaint of painless swelling in the neck for the past year. A 6.5×4.5 cm2 swelling was observed in the anterolateral aspect of the
right side of the neck extending to the thyroid notch. Neck ultrasound and fine needle aspiration cytology showed features suggestive
of a thyroglossal duct cyst. The patient was prepared for the Sistrunk procedure for thyroglossal duct cyst excision. The patient was on
regular follow-up postoperatively for 6 months, and no evidence of any recurrence was seen.

Background: Intussusception is one of the most frequent causes of acute bowel obstruction in infants and toddlers. Abdominal sonogram is highly specific, accurate and is the first line diagnostic modality. The primary treatment options are non-operative hydrostatic or pneumatic reduction. In our institution, we use normal saline for reduction of intussusception under ultrasound guidance (USGR). The aim of the study is to analyse the clinical pattern and treatment outcome of intussusception. Methodology: Retrospective analysis of all cases admitted with intussusception in our department during 2014-2018 was done. Results: 785 cases (527 males: 258 females) with a mean age of 25 months and median of 16 months had abdominal pain (92.5%), vomiting (59%) and blood in stools (32%) as the predominant symptoms. 710/785 cases (90.4%) underwent successful USGR and 75/785 of the failed cases underwent surgery. Age group &lt; 12 months, presence of blood in stools irrespective of its duration a...

Considering the myriad cross-border regions that the EU counts, it is impossible for the European Commission to map detailed territorial cross-border effects in all of the EU's border regions for the impact assessments it conducts. National governments also face obstacles when seeking to cohesively integrate crossborder impact assessments in the existing frameworks that they use to assess the impact of new legislative, policy and enforcement measures. Even border regions or cross-border entities themselves face challenges in implementing impact assessments in their own territories. Despite the need for structural analyses of the border effects of newly adopted legislation and legislation under review, in terms of policy and enforcement, there are issues regarding the availability of academic resources, relevant tools and know-how. For the last couple of years, researchers from Maastricht University have been assessing as a bottom up exercise the potential effects of legislative proposals on the specific Dutch/German and Dutch/Belgium cross-border territories. This article presents the methodology used and the experiences gained from 2016 to 2019 by highlighting a number of interesting cases. It also offers future ideas for conducting similar "bottom-up" regulatory territorial impact assessments in cross-border regions.

Postoperative pain management in paediatric infra-umbilical surgeries remains a challenge. Caudal epidural anaesthesia with Ropivacaine is widely used, but adjuvants such as Fentanyl and Dexamethasone may enhance its analgesic efficacy. This study aimed to compare the analgesic effects of Fentanyl and Dexamethasone as adjuvants to caudal Ropivacaine in paediatric patients undergoing infra-umbilical surgeries. A prospective, randomized, double-blind study was conducted with 54 paediatric patients aged 1-12 years, classified as ASA I or II, undergoing elective infraumbilical surgeries. Patients were randomly divided into two groups: Group F received Ropivacaine (0.25%, 1 ml/kg) with Fentanyl (1 mcg/kg), and Group D received Ropivacaine (0.25%, 1 ml/kg) with Dexamethasone (0.1 mg/kg). Postoperative pain was assessed using the FLACC scale at regular intervals, and the time to first rescue analgesic was recorded. The mean time to first rescue analgesic was significantly longer in Group D (10 hours) compared to Group F (6 hours, p < 0.001). FLACC scores were consistently lower in Group D at all measured time points (p < 0.001), indicating superior analgesia. Both groups maintained stable hemodynamic parameters, and adverse effects were minimal. Dexamethasone as an adjuvant to caudal Ropivacaine provides prolonged and superior analgesia compared to Fentanyl, making it a more effective option for postoperative pain management in paediatric infra-umbilical surgeries.

Освещены вопросы расширения масштабов использования солнечной энергии в жилищно-коммунальном хозяйстве населенных пунктов. Приведен анализ варианта использования комбинированной солнечно-теплонасосной установки для теплоснабжения отдельного двухэтажного коттеджа с открытым бассейном.

Background: Clonidine is an alpha-2 adrenergic agonist which decreases the release of catecholamines at the level of the centers of regulation of blood pressure, and decreases sympathetic tone and the release of circulating catecholamines. Patients and methods: This was a randomized single-blind clinical trial that took place over a period of 4 months. All adults classified as ASA I and II admitted for scheduled surgery and requiring general anesthesia were included. The patients were randomly divided into two groups: group A (clonidine) and group B (non-clonidine). Heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were observed at the following times: at the pre-anaesthetic consultation (t1), at installation on the operating table (t2), 5 minutes after clonidine infusion (t3), 1 st , 3 rd and 5 th minute after tracheal intubation (t4, t5, t6), 1 st , 3 rd and 5 th minute after surgical incision (t7, t8, t9). Results: During the study period, 35 met the inclusion criteria: i.e. 20 patients for group A and 15 patients for group B. In group A, the systolic and diastolic arterial pressures decrease gradually from t3 to t6 and remain very close to the baseline values of the anesthesia consultation. In group B, there is a tendency to increase systolic and diastolic blood pressure compared to baseline values at the same times. Tachycardia is found in group B while a tendency to bradycardia is encountered in group A from t3 to t6. Conclusion: Clonidine helps to control sympathetic hyperactivity, arterial hypertension and reflex tachycardia, induced by tracheal intubation.

Pino Nano tells the story of one of the most famous Italian oncology surgeons, Prof. Pasquale Perri, a doctor of Calabrian origins who today heads the Department of Hepatic-biliary Surgery at the Regina Elena National Cancer Institute in Rome. The story of an all-Italian excellence.
-/Pino Nano racconta la storia di uno dei più famosi chirurghi oncologi italiani, il prof. Pasquale Perri, medico di origini calabresi che oggi guida il Dipartimento di Chirurgia Epaotobiliare dell'Istuituto Nazionale dei Tumori Regina Elena di Roma. Storia di una eccellenza tutta italiana.

Laryngoscopy and endotracheal intubation is often associated with hypertension and tachycardia because of the sympathoadrenal stimulation which is usually transient and lasts for 5-10 minutes. In patients with cardiovascular and cerebrovascular disease, this sudden rise in Heart Rate (HR) and blood pressure can produce deleterious effects in the form of myocardial ischemia, pulmonary edema and cerebral hemorrhage. Many methods have been tried to obtund the haemodynamic response in adult and pediatric patients, but none proved to be ideal. Dexmedetomidine has been particularly effective in blunting the haemodynamic response to laryngoscopy and tracheal intubation. Aims

The surgical treatment of neonates has enjoyed rapid development during the last 50 years. Neonatal surgery has now become an independent branch of general surgery, which requires the expertise of dedicated paediatric surgeons. Much of the development of neonatal surgery is due to the close collaboration between paediatric surgeons, neonatologists, anaesthetists, pathologists, radiologists, biochemists, and nurses. There has been a steady improvement in the outcome of most neonatal diseases requiring surgery. For example at Great Ormond Street Hospital for Children, London, the mortality for the most common congenital intestinal obstructions has declined from 50% in the 1950s and 1960s to 25% in the 1960s and 1970s to a current mortality of less than 5%. The reasons for this improvement can be ascribed to a better understanding of the physiology of surgical neonates, to the advances in fluid management, nutrition, mechanical ventilation, and not least to refinements in surgical techniques. There is still considerable work to be done to improve the survival of neonates with severe conditions such as necrotizing enterocolitis (NEC). Surgery of the gastro-intestinal tract is required for congenital abnormalities and acquired lesions. In this article the authors focus on the most common congenital anomalies of the gastro-intestinal tract requiring surgery. In addition they discuss two acquired conditions requiring surgery in neonates: NEC and hypertrophic pyloric stenosis. It is beyond the scope of this article to discuss anomalies of the abdominal wall, gastro-oesophageal reflux, and anomalies of the pancreato-biliary system.

Introduction: Pediatric surgical admissions are daily practice at peripheral hospital. To design strategy for appropriate diagnosis and management of pediatric surgical patient reported to combined military hospital (CMH) Bogura, Bangladesh. Objectives: To find out the pattern of pediatric surgical admission cases and factors affecting their outcomes. Methods: This case series analysis was conducted from November 2016 to October 2017 at CMH, Bogura. Total 175 patients admitted during this period out of them13 children excluded from study due to parent’s refusal for intervention or discharged against medical advice. In this study total 162 admitted children’s data were analyzed. Results: The study showed emergency cases were predominating 74.69% and elective cases were less common 25.30%. Mortality recorded exclusively in children admitted on emergency basis 6 children (3.70%). Congenital anomaly of GIT was found the leading causes of death in this study 4 (2.46%) children. Conclusio...

Objective. The aim of this study was to correlate the clinical, demographic, and radiographic aspects of 82 cases of florid osseous dysplasia (FOD) from four countries assessed by five reviewers. Study Design. Retrospective data of patients diagnosed with FOD were obtained from archives of five institutes and analyzed according to clinical and radiographic criteria. Results. A total of 82 cases of FOD were included in the study. In the majority (77.5%) of FOD cases, black women were affected. The disease mainly affected the mandible (100%), and the stage of the lesion was directly correlated with the age (P &lt; .05). The rates of convergence showed confluence of assessment in the mandible (posterior), and the highest rate of divergence between the reviewers was in assessing involvement in the maxilla. There were no differences among the characteristics of the lesion provided by the five institutions, except for the variable proportion of black patients affected by the disease. Conc...